Provider Demographics
NPI:1174832737
Name:GIESSER, VERENA (LMT)
Entity Type:Individual
Prefix:
First Name:VERENA
Middle Name:
Last Name:GIESSER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:RONJA
Other - Middle Name:
Other - Last Name:GIESSER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 384535
Mailing Address - Street 2:
Mailing Address - City:WAIKOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96738
Mailing Address - Country:US
Mailing Address - Phone:808-557-8110
Mailing Address - Fax:
Practice Address - Street 1:75-240 NANI KAILUA DR
Practice Address - Street 2:6A
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2074
Practice Address - Country:US
Practice Address - Phone:808-326-9229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT11757174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist